Department of Pediatrics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.
Department of Pediatrics, Yeşilhisar State Hospital, Kayseri, Turkey.
Int J Clin Pract. 2021 Nov;75(11):e14810. doi: 10.1111/ijcp.14810. Epub 2021 Sep 14.
Technetium-99m-dimercapto succinic acid (Tc-99m DMSA) scintigraphy is a commonly used imaging modality in children with urological abnormalities. The radiopharmaceuticals, which have the effects of ionising radiation, are used in this method. This study aimed to investigate the impact of the Tc-99m DMSA scan on renal oxidative stress and mononuclear leukocyte (MNL) DNA damage.
Children, who were followed up by paediatric nephrology at Bezmialem Vakif University and underwent Tc-99m DMSA scintigraphy between April 2015 and January 2016 with the indication of detection of renal scars, were included in this study. The exclusion criteria were nephrolithiasis, history of premature birth and recent urinary tract infection 3 months prior to scintigraphy or antibiotic use in the last 1 month. 3 mL heparinised blood samples were obtained just before, immediately after and 1 week after the scintigraphy. MNL DNA damage, total antioxidant status (TAS) and total oxidant status (TOS) were measured in the blood samples. The oxidative stress index (OSI) was calculated. Spot urine samples were obtained from each patient before and within 3 days after performing the scintigraphy. TAS/Creatinine (TAS/Cr), TOS/Creatinine (TOS/Cr) and N-acetyl-glucosaminidase/creatinine (NAG/Cr) levels were measured in the urine samples.
Twenty-seven children were evaluated. The values between TAS, TOS and OSI levels in serum samples at baseline, immediately after and 1 week after the scintigraphy (P = .105, P = .913, and P = .721, respectively) showed no statistically significant difference. The levels of TAS/Cr, TOS/Cr, NAG/Cr ratios and OSI, which were evaluated from urine samples before and within 3 days after the scintigraphy scan were also similar (P = .391, P = .543, P = .819 and P = .179, respectively). The levels of DNA damage only increased following scintigraphy scan and decreased a week later (P < .05).
The effect of Tc-99m DMSA scintigraphy is insufficient to create oxidative damage, but it can cause DNA damage via the direct impact of ionising radiation which can be repaired again in a short time.
锝-99m 二巯丁二酸（Tc-99m DMSA）闪烁扫描是一种常用于泌尿系统异常儿童的成像方式。该方法使用放射性药物，这些药物具有电离辐射的作用。本研究旨在探讨 Tc-99m DMSA 扫描对肾脏氧化应激和单核白细胞（MNL）DNA 损伤的影响。
本研究纳入了 2015 年 4 月至 2016 年 1 月期间在贝济麦勒瓦基夫大学儿科肾病科接受 Tc-99m DMSA 闪烁扫描的儿童，这些儿童的扫描指征为检测肾瘢痕。排除标准为肾结石、早产史和扫描前 3 个月内近期尿路感染或扫描前 1 个月内使用抗生素。在闪烁扫描前、扫描后即刻和扫描后 1 周采集 3ml 肝素化血样。测量血样中的单核白细胞 DNA 损伤、总抗氧化状态（TAS）和总氧化状态（TOS）。计算氧化应激指数（OSI）。在进行闪烁扫描前和扫描后 3 天内从每位患者采集尿液标本。测量尿液标本中的 TAS/肌酐（TAS/Cr）、TOS/肌酐（TOS/Cr）和 N-乙酰葡萄糖胺酶/肌酐（NAG/Cr）水平。
共评估了 27 名儿童。闪烁扫描前、后即刻和 1 周后血清样本中 TAS、TOS 和 OSI 水平的差异无统计学意义（P=0.105、P=0.913 和 P=0.721）。从闪烁扫描前后 3 天内采集的尿液样本中评估的 TAS/Cr、TOS/Cr、NAG/Cr 比值和 OSI 也相似（P=0.391、P=0.543、P=0.819 和 P=0.179）。只有在闪烁扫描后 DNA 损伤水平才会增加，一周后才会降低（P<0.05）。
Tc-99m DMSA 闪烁扫描的影响不足以造成氧化损伤，但它可以通过电离辐射的直接影响造成 DNA 损伤，这种损伤可以在短时间内得到修复。
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